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Non-surgical resolution of pneumocephalus following a sneeze
  1. Anna Tankersley1,
  2. Sheena Khan1,
  3. Kaitlyn Estes1 and
  4. Cameron Paisley2
  1. 1UAB School of Medicine, Birmingham, Alabama, USA
  2. 2The University of Alabama College of Community Health Sciences, Tuscaloosa, Alabama, USA
  1. Correspondence to Sheena Khan; skhan7{at}uab.edu

Abstract

Pneumocephalus is defined as the abnormal presence of air in the intracranial cavity. Pneumocephalus is most commonly caused by trauma, but there are rare reports of pneumocephalus secondary to allergy-induced sinusitis. In this report, we present a woman in her 60s who presented to the emergency department with a chief complaint of headache after experiencing a ‘popping’ sensation in her ears while sneezing. Over the course of a day, she began experiencing severe pain across the forehead along with copious amounts of clear rhinorrhea. A head CT without contrast was ordered, and findings revealed large amounts of intracranial air visualised diffusely throughout the subarachnoid spaces and the anterior horn of the left lateral ventricle. A diagnosis of pneumocephalus was confirmed. This patient made a full recovery without surgical intervention. Standard conservative therapy included bed rest, head elevation, avoidance of activities that increase intracranial pressure and antibiotic prophylaxis for meningitis.

  • Neuroimaging
  • Headache (including migraines)

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: AT, SK and KE. The following authors gave final approval of the manuscript: AT, SK, KE and CP.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.